ELSA EKELIN: Communication between General Practitioner (GP) and Patient with Chronic Pain and Opioid Treatment

Project description

Background

Despite weak evidence, opioid treatment is commonly prescribed for patients with chronic pain. GPs does not follow guidelines for opioid treatment and there is a lack of knowledge regarding chronic pain in primary health care. There is reason to believe that psychological mechanisms plays an important role in the decision to prescribe. The first study, published in 2018, demonstrated that GPs experience the demand for renewal of weak opioids as a dilemma, and that they use active and passive strategies to deal with this. To better understand opioid prescription practice, the interaction between patient and doctor needs to be studied, where the decision to prescribe is actually made.

Aim

To understand long term opioid treatment by exploring the communication between GP and patient with chronic pain

Method

The communication between GP and patient with chronic pain and opioid treatment will be explored by video recording. The GPs understanding and assessment of patient’s complaints and decision-making regarding treatment will be examined by video stimulated recall (VSR) interview. Data from VSR interviews will subsequently be integrated with observed data of communication, as well as data from patient interview and survey regarding experienced validating and invalidating behavior.

Relevance

Research on opioid treatment is generally of great interest due to recent rise in prescriptions internationally. It is urgent to find new strategies to reduce negative effects of opioids. Until now, the study focus has mainly been on patient or prescriber factors or structural conditions for the prescriber. The area between patient and prescriber is not further studied. This project will provide an increased understanding of why GPs prescribe opioids to patients with long-term pain.